Emergency Information

Patients, the following information is provided to help you assess your emergency and to remind you of what steps to take following particular procedures. This advice is in no way a substitution for emergency treatment but a guide to follow as you determine if you need an emergency visit. Our emergency contact number is 202-487-4753 . If you do not receive a return call within 24 hours and you cannot wait any longer for treatment, please refer to our emergency network contact information below. If you have a facial swelling or abscess, please make an emergency visit as soon as possible. Please have a pharmacy number handy, in case we recommend antibiotics immediately.

CLASSIC EMERGENCY SYMPTOMS

LOST OR BROKEN FILLING
If you do not have substantial discomfort, call and schedule an appointment. You may also place a temporary filling in the tooth yourself. You may purchase Temporary filling material in the toothpaste section or use partially chewed sugarless gum to stuff the hole.

CROWN CAME OFF
You should try to replace the crown using a small amount of chap stick to hold it on your tooth until you can be seen in the office.

TRAUMA FROM ACCIDENT/FALL/PHYSICAL ASSAULT
If any of your teeth were knocked out, place them in milk after rinsing them off and take with you to the emergency visit. If you can reasonably place them back in their correct space, do so and immediately make an emergency visit. If you hit or jam your front teeth and do not have any major discomfort, you should still be evaluated soon and subsequently to assure that the nerves of your teeth were not damaged. If your tooth shifts but does not come out of your mouth, try to reposition it and make an emergency visit.

SYMPTOMS POSSIBLY RELATED TO TEETH GRINDING AND/OR CLENCHING
1. Pain with eating firmer or hard foods but fine otherwise
2. Temperature sensitivity
3. Headaches
4. Jaw soreness
5. Jaw pain
6. Ear pain
7. Pressure in gums
8. Pain or discomfort in upper and lower; pain moves from one area to another
9. Swollen lymph nodes under chin
10. Bite is off. You can mask some of your symptoms with 800mg of Ibuprofen every 6-8 hours until you are evaluated in the office. Warm compresses along with facial massage helps to diminish some symptoms and lessen muscle tension. We recommend you eating a soft diet and avoid chewing gum. You most likely need a night mouth guard. As a temporary measure, you can obtain one in the toothpaste section that you mold at home. A custom fitted guard would be made by us after taking an impression.

BLEEDING GUMS
If you do not have substantial discomfort along with the unusual bleeding, then schedule an appointment for evaluation. If you have pain, call for an emergency visit.

GUM PAIN
Pain from temperature sensitivity should be evaluated but is not an emergency. Pain when brushing/flossing should be evaluated but is not an emergency. Pain with eating hard foods is also not an emergency.

POST-OPERATIVE INFORMATION

DEEP FILLING WITH PULP CAP LINER
You may experience sensitivity from icy colds or coffee hot. This is normal and should disappear over the next couple of weeks but no more than 4 weeks. If such sensitivity persists, the tooth may require an additional procedure. Call the office to have tooth re-evaluated. If you experience unprovoked pain or discomfort, your tooth may have permanent nerve damage and require a root canal. We can perform the root canal or refer you to an Endodontist.

FILLINGS, CROWNS, BRIDGES, INLAYS / ONLAYS
You have just had treatment which may result in the development of temporary symptoms. If you were given anesthesia (shot for your procedure, we advise you to drink caffeinated beverages or orange juice to reduce the time for numbness. You should wait for the numbness to fade prior to eating (1-2 hours). If you can avoid chewing on the treated teeth until the next day please do so.
If you develop temperature sensitivity, your bite may need adjusting so call us to schedule a time to evaluate and adjust. This means your filling or crown or inlay is too bulky and needs to be adjusted. If you experience pain or awkwardness with chewing, your bite is too high and needs adjusting.
If you were told that your filling is very large in size, it can transmit temperature sensitivity to your tooth. This typically subsides over a couple of months. If you experience pain or slight swelling in the area that anesthesia (shot) was administered. Sometimes, it even feels like a sore throat. These symptoms go away within days but rinsing periodically with warm, salty water and taking over the counter pain medicine is suggested.

DENTURES, COMPLETE OR PARTIAL
Whenever your dentures are not in your mouth, they should at least be kept in plain water to prevent warping and changing shape. You need to purchase a denture bath at pharmacy for cleaning them. Also purchase cleaning tablets. Never use toothpaste and a regular toothbrush on your dentures because they will become scratched and eventually smelly. There is a soft denture brush that can be purchased. You need to eat soft foods for 6-8 weeks to allow your gums and tongue a period of adjustment. Overcook your meats and vegetables to make them tender/soft. Do not try to eat hard foods like raw vegetables, ice, etc… During this adjustment eat slowly. You may develop sore spots underneath certain areas of your dentures, on your gums. This is typical and can be relieved. Please call and make a denture adjustment appointment. Some individuals may need several adjustments, before dentures are comfortable. Do not become frustrated with your dentures. Keep focused and keep wearing them. It may also be difficult to speak properly, at first. Use the words Mississippi and Emma as practice words. The more these words sound normal, the more normal your speech will sound.

PERIODONTAL / ORAL SURGERY
In some cases, a dressing will be replaced over the area. The dressing serves to protect the area of the surgery and to keep you comfortable. If small pieces break off. Do not be alarmed, if a large piece, or if the dressings are uncomfortable, call the doctor. As an emergency measure cover the womb with softened wax. Do not play with dressing with tongue or fingers. This dressing serves as bandage to protect the wound. Avoid tart or spicy foods. Drink fruit juices with a straw. Some swelling may occur. This is to be expected. Place ice pack over the area that has undergone surgery and rinse frequently and gently with warm water (one glass) with one teaspoon of salt. A slight amount of seepage may occur, giving your saliva a reddish color (do not be alarmed). If the seepage persists call the office during normal business hours or call our emergency number (please refer to emergency numbers listed below). Take pain medication as prescribed. Only brush parts of mouth on which surgery was not performed. Brush only the biting surfaces of teeth where surgery was performed. Be sure to brush! When dressing is placed brush and use floss (not under the gum line). Rinse mouth carefully after eating. Clean outside of dressing with moistened cotton swab or Q-tips.

ENDODONTIC TREATMENT
You have just had a root canal performed or started. If you do not follow through with completion of your root canal it may lead to the tooth becoming unrestorable. It is possible for you to experience some pain or discomfort for days after the procedure. Your dentist will discuss your need for medications or if you experience discomfort ask for a pain reliever. Do not eat on your treated tooth. Root canal treated teeth become weak and brittle. You will need to return to your dentist to have your tooth restored to whole. It will need an inner filling (core) and possibly a pin (screw-like) to hold the core. You will also need a crown (cap) to allow you to use your tooth normally. It is highly recommended that you begin restoring your tooth as soon as possible. It is hard to predict how long it will take to recover however the normal recovery period is two weeks or more. If your root canal is incomplete you will need to make a follow up appointment as soon as possible to complete the procedure.

SCALING AND ROOT PLANNING
Take over the counter headache medicine for pain and discomfort. Eat soft foods for one week; nothing spicy, extremely hot or cold. Do not be alarmed if you see blood oozing from your gums immediately several days after your treatment. Rinse mouth salt water to help reduce soreness and inflammation. Brush your teeth but do not overlap your gum tissue to avoid irritation. You may be prescribed an oral tablet called Periosteal (follow directions for use) or a medicated rinse for use following your treatment. Please follow your normal hygiene routine on the day following your treatment but be gentler with your brushing for two weeks. Smoking will negatively impact your treatment outcome. If you clinch or grind your teeth and do not wear a guard, your treatment results will be negatively impacted.

FULL MOUTH DEBRIDEMENT
Do not be alarmed if you see blood oozing from your gums after the procedure for several days. Eat soft and bland (non-spicy) food for one week, nothing hard or crunchy such as seeds or popcorn etc… Take ordinary headache medications for pain or discomfort. Rinsing with warm salt water helps reduce soreness and inflammation. Do not overlap onto your gums when you brush your teeth following the procedure. Please follow your normal and improved hygiene routine on the following day. Smoking will negatively impact the results of your gum treatment. If you grind or clench your teeth and do wear a night guard, your treatment results will be negatively impacted. Please call the office if you have any questions.

DENTAL EXTRACTION
Removing the teeth does not always remove all the infection, if present and it may be necessary to have further treatment. Some of the risks involved in having teeth removed are pain, swelling, spread of infection, dry socket, loss of feeling in your teeth, lips, tongue and surrounding tissues (parathesia) that can last for an indefinite period of time (days or months) or fractured jaw. You may need further treatment by a specialist or even hospitalization if complications arise. Please call the office if you have any questions.

Below is a list of Doctors that you can call if you have an emergency if our office is closed / you cannot reach us.
Dr. Jeffrey Gittleman (Oral Surgeon)
1234 19th Street N.W.
Washington, D.C. 20036
(202) 223-3391